J Korean Soc Traumatol.  2015 Mar;28(1):34-38. 10.0000/jti.2015.28.1.34.

Application of Extracorporeal Membranous Oxygenation in Trauma Patient with Possible Transfusion Related Acute Lung Injury (TRALI)

• Lee DS
• Park CM

• KMID: 2094445
• DOI: http://doi.org/10.0000/jti.2015.28.1.34

Abstract

The case of a patient with a transfusion-related acute lung injury (TRALI) to whom extracorporeal membrane oxygenation (ECMO) had been applied is reported. A 55-year-old male injured with liver laceration (grade 3) without chest injury after car accident. He received lots of blood transfusion and underwent damage control abdominal surgery. In the immediate postoperative period, he suffered from severe hypoxia and respiratory acidosis despite of vigorous management such as 100% oxygen with mechanical ventilation, high PEEP and muscle relaxant. Finally, ECMO was applied to the patients as a last resort. Aggressive treatment with ECMO improved the oxygenation and reduced the acidosis. Unfortunately, the patient died of liver failure and infection. TRALI is a part of acute respiratory distress syndrome (ARDS). The use of ECMO for TRALI induced severe hypoxemia might be a useful option for providing time to allow the injured lung to recover.

Keyword

Adult; Blood transfusion; Extracorporeal membrane oxygenation; Respiratory distress syndrome; Trauma

MeSH Terms

Acidosis
Acidosis, Respiratory
Acute Lung Injury*
Adult
Anoxia
Blood Transfusion
Extracorporeal Membrane Oxygenation
Health Resorts
Humans
Lacerations
Liver
Liver Failure
Lung
Male
Middle Aged
Oxygen*
Postoperative Period
Respiration, Artificial
Respiratory Distress Syndrome, Adult
Thoracic Injuries
Oxygen